Drinking & Smoking During Lockdown

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Drinking & Smoking During Lockdown

Post by trader32176 »

Changes in drinking and smoking during England’s first COVID-19 lockdown


https://www.news-medical.net/news/20210 ... kdown.aspx

The worldwide spread of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) that causes COVID-19 infection in early 2020 prompted many nations to close their borders and institute mandatory lockdowns. While lockdowns abruptly stopped daily life, researchers from the University College London and the University of Sheffield found drug-seeking behaviors did not.

The research team previously analyzed behavioral changes in April 2020, which was the first month of lockdown.

“The first Covid-19 lockdown in England in March-July 2020 was associated with increased smoking prevalence among younger adults, and increased prevalence of high-risk drinking among all sociodemographic groups,” wrote the study authors.

While they found an increase in drug use, whether this was a short-term or long-term response to the pandemic had remained unknown.

The study “Moderators of changes in smoking, drinking, and quitting behavior associated with the first Covid-19 lockdown in England” is available as a preprint on the medRxiv* server, while the article undergoes peer review.

Changes in smoking and alcohol use are not temporary

The researchers looked at how smoking and drinking behavior changed because of lockdown. The researchers randomly sampled 1,700 adults per month and interviewed them about their drug experience through phone or the computer. A total of 36,980 adults participated in the study.

They compared people’s drug use a year before lockdown, months before the lockdown defined as August 2019 to February 2020, to the first lockdown in England, which took place from April to July 2020. Because the lockdown was lifted on July 4, 2020, the researchers excluded data for that particular month.

Comparing drug use over a similar time period helped researchers rule out seasonal changes as a possible explanation for behavioral changes.

They found various changes in smoking and drinking behavior during lockdown than before lockdown. In addition, the increased drug behavior observed in the first month of lockdown persisted for the whole four months of lockdown.

“The only exception was a change in the use of support, which fluctuated and was not statistically significant. This suggests increases in high-risk drinking, efforts to reduce alcohol consumption and quit smoking, and success in the latter were not short-lived, acute reactions to lockdown,” wrote the researchers.

Younger adults showed greater changes in smoking behavior

Adults aged 18 to 34 reported higher rates of smoking during lockdown compared to older adults. The authors provide several explanations for this result, including older people being a high-risk group during the pandemic and thus, being more conscientious of their health. They also suggest younger adults may have been using smoking as a coping mechanism for the loss of significant life changes and other pandemic-related stress.

Results also showed a 156.4% increase in smoking cessation in past-year smokers and an increased 39.9% attempt to quit smoking during the lockdown. Attempts to quit were more prevalent amongst the 18-34 age group than older adults in the 35-59 and over 60 group.

“The apparent discordance between increased prevalence and increased quit attempts among younger adults does not have an obvious explanation and warrants further investigation,” wrote the authors.

Women and socioeconomic status were factors for heavy drinking

Results showed all adults increased their alcohol use by 39.5% while in lockdown compared to the same time period the year before. Women were the heavier drinkers, with a 55.4% increase in alcohol use compared to the previous year. Additionally, people in less socioeconomically advantaged groups reported a 30.7% increase in drinking.

For high-risk drinkers, the researchers found a 75.5% increase in attempts to limit drinking during the pandemic lockdown compared to the same time period in 2018/2019. About 120.5% of younger adults and 81.7% of older adults attempted to reduce alcohol use.

The researchers note that the 35-59 age group showed the smallest changes in limiting their alcohol intake, but this might be due to an already high rise in alcohol reduction attempts before lockdown.

Only people of higher socioeconomic status reported more attempts to limit drinking.

Effect of lockdowns on public health

With over 4 million coronavirus cases in the United Kingdom and over 110 million coronavirus cases worldwide, the possibility for future lockdowns is high.

The researchers suggest expanding on these findings to better inform how lockdowns impact public health. “Further analyses of longer-term trends beyond the first lockdown and during subsequent periods of differing Covid-19 restrictions will provide interesting insight into the duration of these changes and the extent to which they recurred during later lockdowns.” The study results may help promote more vital evidence-based reduction techniques to avoid high drug use.

*Important Notice

medRxiv publishes preliminary scientific reports that are not peer-reviewed and, therefore, should not be regarded as conclusive, guide clinical practice/health-related behavior, or treated as established information.

Journal reference:

Jackson S, et al. Moderators of changes in smoking, drinking, and quitting behaviour associated with the first Covid-19 lockdown in England. medRxiv, 2021. doi: https://doi.org/10.1101/2021.02.15.21251766, https://www.medrxiv.org/content/10.1101 ... 21251766v1
Posts: 1779
Joined: Fri Jun 26, 2020 5:22 am

Re: Drinking & Smoking During Lockdown

Post by trader32176 »

New paper discusses how smoking may affect risk for COVID-19


https://www.news-medical.net/news/20210 ... ID-19.aspx

A new paper published online in the Annals of the American Thoracic Society discusses how smoking may affect risk for COVID-19 and the types of research that are needed to better understand the link between smoking and COVID-19 risk.

In "Smoking and COVID-19: The Real Deal," Enid Neptune, MD, and Michelle N. Eakin, PhD, of the Division of Pulmonary and Critical Care Medicine, Johns Hopkins University, discuss research to date on this topic and propose areas of research that can help clarify this relationship.

Studies have shown that current smokers with COVID-19 have twice the risk of dying in the hospital as nonsmokers. However, the data on whether tobacco use increases the risk of SARS-CoV-2 infection is mixed.

" The relationship between smoking and COVID-19 is complex, and much of the research to date has been inconclusive or contradictory. To resolve this issue, rigorous study design is needed. This research should accurately confirm smoking exposure, with readouts that distinguish infection from sickness and provide an objective assessment of confounding factors."

- Dr. Enid Neptune, Division of Pulmonary and Critical Care Medicine, Johns Hopkins University

Dr. Neptune adds that a significant amount of research has focused on whether smoking has an effect on lung ACE2, a protein that provides an entry point for SARS-CoV-2 (the virus that causes COVID-19) to attach itself to cells inside the airways and airspace of the lungs. "The use of ACE2 expression as a quantifiable index of SARS-CoV-2 infectivity and morbidity is highly problematic," she said. "A strenuous exploration of how and whether tobacco smoke and nicotine affect SARS-CoV-2 infectivity or viral load (amount of virus) is needed to provide context to the ACE2 expression data."

According to Drs. Neptune and Eakin, the following topics should also be addressed in future research:

Airway/Airspace Injury (Direct Toxic Effects). It will be especially important to describe the effects of tobacco smoke on nasal tissue (epithelium), as the nose is the primary entry point for SARS-CoV-2 and little research has been done on smoke's effects on this part of the anatomy. The researchers believe advanced preclinical and in vitro ("in the laboratory") models of smoking plus SARS-CoV-2 infection will provide the most reliable answers to this question.

Inflammation Profile That Supports Viral Pathogenesis. Another important research question is whether smoking compromises the body's inflammatory response to viruses or contributes to an inability to regulate these responses. Researchers have previously shown that smoking affects the body's ability to respond to many respiratory viruses; we need to know more about whether this holds true for SARS-CoV-2.

Disturbances in RAS Signaling. Renin Angiotensin Signaling (RAS) proteins control intracellular signaling pathways that impact lung health. There is some evidence that disruption of conventional RAS signaling protects against lung injury from cigarette smoking in chronic obstructive pulmonary disease (COPD), which is associated with improved COPD outcomes, but we do not know whether this also holds true for COVID-19. Measurements of the activity of RAS processing enzymes and the proteins produced by this activity in smoking and non-smoking COVID patients would provide some guidance for pilot therapeutic studies.

Nicotine Signaling and SARS-CoV-2 Infection. Some research has shown that nicotine exposure and nicotine signaling (within the brain) may reduce SARS-CoV-2 infection and illness. The effects of nicotine should be studied, in addition to studying smoking, since nicotine-delivering e-cigarettes are now so widely used. This research should be done very cautiously, because nicotine dependence has major public health consequences.

"There are several other areas of smoking-COVID research that might be explored, beyond those discussed in our paper," Dr. Neptune said. These include:

Whether the stress of life during the pandemic has led to increased use of tobacco for self-medication;

If hospitalization for COVID-19 helps smokers quit;

Whether altered taste and smell due to COVID-19 reduce the desire to smoke.

Dr. Neptune concludes, "Our paper shows that the impact of tobacco exposure on the development of COVID-19 is challenging to address with clinical studies, and needs rigorous validation with cell and animal studies. Taken together, the multiple published studies on smoking and COVID have not yet resolved the issue. Our intention in publishing this paper is to identify the interpretative challenges of the overall dataset and recommend ways forward."


American Thoracic Society (ATS)
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Re: Drinking & Smoking During Lockdown

Post by trader32176 »

Alcohol and tobacco sales nationwide rose in the early months of COVID-19


https://www.news-medical.net/news/20210 ... ID-19.aspx

COVID-19 has taken a huge medical, emotional and economic toll on Americans. Now, new Keck Medicine of USC research shows that the pandemic may also have harmful indirect consequences.

Alcohol and tobacco sales nationwide rose in the early months of COVID-19, according to a study appearing in the Annals of Internal Medicine today. From April - June 2020, researchers found that sales of these substances increased 34% and 13% respectively when compared to the same months in 2019.

" These are significant jumps, and show that the stress, boredom and loneliness caused by the pandemic may have led to increased alcohol and tobacco use."

- Brian P. Lee, MD, MAS, Study Lead Author and Hepatologist, Liver Transplant Specialist, Keck Medicine and the USC Institute for Addiction Science

Tobacco and alcohol abuse are the second and ninth largest contributors to global deaths, causing some eight million deaths each year worldwide.

Lee and his colleagues decided to study alcohol and tobacco purchasing patterns after noticing that in 2020, Keck Hospital of USC admissions for alcohol-associated liver disease (cirrhosis or alcoholic hepatitis) were up approximately 30% compared to the year before. Some patients also admitted to using alcohol to handle pandemic-related stressors.

The doctors wondered if the trend they were witnessing locally was also happening nationally. And if one substance was being abused, they wondered if a second -- tobacco -- might be as well.

Seeking national data, they turned to the Nielsen National Consumer Panel, which tracks the spending habits of approximately 70,000 households in the United States over time and is designed to be nationally representative. People are given a handheld scanner or use a smart-phone app to scan products at stores to report their purchases.

Researchers compared alcohol and tobacco sales between the months of April - June in 2020 with the same time period in 2019. They set up controls to offset extenuating factors, such as restaurants and bars being closed during these months, which could independently cause an uptick in alcohol sales.

When they calculated their results, they found that from 2019 to 2020, tobacco sales increased in households across all demographics and alcohol sales increased across nearly all demographics as well. Sales increases for both substances were the highest, however, among younger adults, ethnic minorities, those with younger children and/or large families and those with higher incomes.

"We hypothesized that these subgroups, such as those with younger children, were buying more alcohol and tobacco because they felt more stressed than other segments of the population," said Lee, who is also an assistant professor of clinical medicine at the Keck School of Medicine of USC. "For those with a higher income, sales might have increased simply because they have greater disposable income," he added.

The data also revealed that sales of hard liquor increased more than wine and beer, a result Lee found troubling. "Liquor has the highest alcohol content and could be a sign of problem drinking," he said.

Lee believes that the study may reveal a previously unrecognized COVID-19-related public health issue. "This study draws attention to the fact that many people across the country might be self-medicating as a way to cope," he said. "By spotlighting this issue, individuals can identify this behavior as potentially harmful and substitute drinking or smoking with healthier activities. Mental health professionals and medical institutions, in addition to policymakers, can also develop interventions to help them."

Other Keck Medicine physicians involved in the study are Norah Terrault, MD, a Keck Medicine gastroenterologist and chief of Gastroenterology and Liver Diseases at the Keck School; Jennifer Dodge, MPH, an assistant professor of research medicine and preventive medicine at the Keck School; and Adam Leventhal, PhD, a professor of preventive medicine at the Keck School.

The researchers hope to conduct further studies to see if this three-month trend has sustained throughout the pandemic.


University of Southern California - Health Sciences

Journal reference:

Lee, B. P., et al. (2021) Retail Alcohol and Tobacco Sales During COVID-19. Annals of Internal Medicine. doi.org/10.7326/M20-7271.
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